California Department of Mental Health

1. Office of Suicide Prevention California Department of Mental Health Suicide Prevention in California:Everyone is Part of the Solution Madera County Regional Suicide Prevention Coordinators Meeting Wednesday October 27th, 2010

2. Topics of Discussion • Suicide trends • At-risk populations • California Strategic Plan on Suicide Prevention • Office of Suicide Prevention • The Public Health Approach to Prevention

3. Suicide in California California Department of Public Health (2008)

4. County Data Profile Madera County Office of Suicide Prevention, Department of Mental Health (2007)

5. Five Leading Causes of Fatal Injuries in Madera County California Department of Public Health (2007) [http://www.applications.dhs.ca.gov/epicdata/default.htm]

6. Leading Causes of Fatal Injuries by Age Group in Madera County California Department of Public Health (2007) http://www.applications.dhs.ca.gov/epicdata/default.htm

7. Suicide Among Specific Populations • Individuals with Mental Health Disorders* • 90% of suicide deaths involve a diagnosable mental health or substance abuse disorder • Certain diagnoses, such as bipolar disorder and schizophrenia, are associated with elevated risk • In the California Violent Death Reporting System (CalVDRS), as many as 25% had a diagnosed mental health disorder; half were in treatment and 3 in 10 were never treated** • Veterans*** • Largest veteran population of any state • Higher risk of suicide than non-veterans • More likely to be precipitated by a physical health problem and current depressed mood • More likely to be first time attempters and to use a gun * See California Strategic Plan on Suicide Prevention. ** Risk factors for suicide from CalVDRS. AAS Conference, San Francisco, April 18, 2009*** ***Characteristics of veteran suicides in California. DOD-VA Conference, San Antonio TX, January 13,2009

8. Suicide Among Specific Populations • Rural Residents • Consistently higher rates in rural counties in CA as well as rural states • Possible relationship with firearm ownership rates See California Strategic Plan on Suicide Prevention.

9. Young Latina Risk: National Youth Risk Behavior Survey Percentage of HS students who… Seriously considered attempting suicide* • 15.4% Hispanic (vs. 13.1% White & 13.0% Black) Made a plan about how they would attempt suicide* • 12.2% Hispanic (vs. 10.3% White & 9.8% Black) Actually attempted suicide* • 6.1% Hispanic (vs. 5.0% White & 7.9% Black) Had to be treated by medical professional after suicide attempt (injury, poisoning, overdose)** • 3.2% Hispanic (vs. 2.1% White & 2.0% Black) Overall, females were more likely than males to do the above Provided by Dr. Sergio Aguilar-Gaxiola *National Youth Risk Behavior Survey (2009) **National Youth Risk Behavior Survey (2005)

10. Suicide Attempts in the Young Latina Population • Latinas are the largest minority group of girls among 12-17 year olds in the country and growing • Roughly 50% of Madera County’s population is Hispanic/Latino* * 2006-2008 American Community Survey 3-year estimates from the U.S. Census Dr. Sergio Aguiltar-Gaxiola presentation citing CDC data

11. Risk and Protective Factors for Latinos Individual Level Protective Factors Risk Factors Dr. Sergio Aguilar-Gaxiola, 2008, citing Caine 2004 as adapted from Crosby

12. Risk and Protective Factors for Latinos Interpersonal Level Protective Factors Risk Factors Dr. Sergio Aguilar-Gaxiola, 2008, citing Caine 2004 as adapted from Crosby

13. Risk and Protective Factors for Latinos Community Level Protective Factors Risk Factors Dr. Sergio Aguilar-Gaxiola, 2008, citing Caine 2004 as adapted from Crosby

14. Risk and Protective Factors for Latinos Societal Level Protective Factors Risk Factors Dr. Sergio Aguilar-Gaxiola, 2008, citing Caine 2004 as adapted from Crosby

15. California’s Suicide Prevention Milestones • Office of Suicide Prevention established on February 6, 2008 • The California Strategic Plan on Suicide Prevention: Every Californian is Part of the Solution (approved by the Governor’s Office on June 30, 2008) • Full Plan and Executive Summary available in hard copy and on DMH website* *http://www.dmh.ca.gov/PEIStatewideProjects/SuicidePrevention.asp

16. www.dmh.ca.gov/ PEIStatewideProjects/ SuicidePrevention.asp A blueprint for action at the state and local levels to reduce suicide and its tragic consequences.  It is built upon the vision that a full range of strategies – from prevention and early intervention to treatment and postvention – should be implemented that appropriately targets Californians of all ages and diverse backgrounds.  Dr. Sergio Aguilar-Gaxiola presentation

17. Strategic Directions Create a System of Suicide Prevention ; Implement Training and Workforce Enhancements to Prevent Suicide; Educate Communities to Take Action to Prevent Suicide; Improve Suicide Prevention Program Effectiveness and System Accountability. Source: www.dmh.ca.gov/Prop_63/MHSA/Prevention_and_Early_Intervention/docs/ SuicidePreventionCommittee/FINAL_CalSPSP_V9.pdf

18. California Strategic Plan on Suicide Prevention Strategic Direction 1: Create a System of Suicide Prevention State Level Next Steps Local Level Next Steps

19. California Strategic Plan on Suicide Prevention Strategic Direction 2: Implement workforce and training enhancements to prevent suicide State Level Next Steps Local Level Next Steps

20. California Strategic Plan on Suicide Prevention Strategic Direction 3: Educate communities to take action to prevention suicide State Level Next Steps Local Level Next Steps

21. California Strategic Plan on Suicide Prevention Strategic Direction 4: Improve suicide prevention program effectiveness and system accountability State Level Next Steps Local Level Next Steps

22. Goals of the California Office of Suicide Prevention • Expand the number and capacity of accredited suicide prevention hotlines. • Develop a web based resource on suicide prevention that is specific to California. • Build a coordinated system of suicide prevention among state, regional, and local organizations. • Support suicide prevention training opportunities in California. • Work with state & local partners to promote veterans’ mental health

23. California Accredited Crisis Centers with Crisis Hotlines Suicide Prevention and Crisis Services of Yolo County The Effort (Sacramento) Suicide Prevention and Community Counseling (Marin) Contra Costa Crisis Center Kern County Mental Health San Francisco Suicide Prevention Suicide Prevention and Crisis Intervention Center (San Mateo) Crisis Support Services of Alameda County Suicide Prevention Center, Didi Hirsch Community Mental Health Center (Los Angeles) OptumHealth Crisis Line (San Diego)

24. National Partnerships • Suicide Prevention Resource Center • National Suicide Prevention Lifeline • American Association of Suicidology • Substance Abuse and Mental Health Services Administration • Jed Foundation • Trevor Project • American Foundation for Suicide Prevention • US Dept of Veterans Affairs • Suicide prevention coordinators

25. State Level Partnerships • California Dept. of Veterans Affairs • California Army National Guard • California Department of Aging • California Department of Education • Higher Education (UC, CSU, community colleges) • Department of Alcohol and Drug Programs • Board of Behavioral Sciences • Office of Statewide Health Planning and Development • Department of Social Services

26. Local Partnerships • County OSP Liaisons • 23 counties and growing • Monthly conference calls • Consortium of CA Crisis Centers • 10 crisis centers participating • Face to face meeting on November 5th; monthly conference calls • Ongoing technical assistance to a wide range of stakeholders, including development of PEI plans

27. Suicide Prevention Resource Center (www.sprc.org)

28. Suicide Prevention Planning • Build a coalition • Mental health, law enforcement, emergency medical services; survivors and higher risk communities (e.g. youth, the elderly, or those with mental health or substance use disorders) • Meet specific community needs; cross the usual silos • Examine the data • Define the problem by collecting data and other information • Comprehensive community assessment • Sources of strength as well as risk • Plan the strategy • Develop an action plan • Obtain resources, implement interventions, sustain the effort • Find funding • Public funds, grants, foundations; leveraging resources • Evaluate • Measure effectiveness, ongoing quality improvement; justify funding Suicide Prevention Resource Center (www.sprc.org)

29. Contact the Office of Suicide Prevention